Risk Factors for Trachoma: A Case Control Study at Yaala Sub-District, Wa District, Upper West Region

Abstract

Trachoma is the second leading cause of blindness worldwide with approximately 150 million people having active ocular infection and at least 5.5 million blind due to corneal scaring. In Ghana, the disease is a public health problem in the Upper and Northern Regions. In many trachoma endemic areas factors like lack of water, lack of facial cleanliness among children, overcrowding in a household (especially of children) and poor environmental sanitation contribute to the transmission of the disease. The Wa District Health Administration has initiated a Trachoma Control Programme in the district with the aim of controlling the disease. To facilitate the implementation of the programme, the DHMT needs to know the specific risk factors that are associated with trachoma in the district so as to prioritise the strategies of the control programme. A case control survey to determine the risk factors for trachoma in the Yaala subdistrict was conducted among children aged 1-9 years and their mothers/caregivers using clinical examinations, observation studies and questionnaire administration. Four trachoma endemic communities were conveniently selected (based on the data from the trachoma rapid assessment that was carried out in the sub-district) and the eyes of 245 children aged 1-9 years were examined. All mothers/caregivers of the children with tracho (cases) and mothers/caregivers of the children without trachoma (controls) were interviewed. Observation studies were also conducted in the study communities to strengthen the outcome of the interview. The prevalence of active trachoma among children aged 1-9 years in the study area was 17.5%. Distance more than 1 mile walk from a household (OR = 2.48, X2=5.91, P-value = 0.02), Indiscriminate refuse disposal (OR = 3.37, X2=5.03, Pvalue = 0.03) and keeping cattle inside or near a household (OR = 2.67, X2=5.03, P-value=0.03) were found to have statistically significant association with trachoma. The recommendations are: • More bore-holes should be constructed in the communities to ensure that the people do not travel long distances to fetch water. • Mothers/caregivers should be educated on the need to use water for washing faces of their children regardless of the quantity of water in a household. • Communities should be educated on compose method of refuse disposal. • Health Inspectors should be charged to intensify their activities in the communities to ensure good environmental sanitation. • Cattle owners in the communities should be educated to keep their cattle far way from households.